Hi, How can I place an image parallel to 2 text fields

How can I place an image parallel to 2 text fields and also leave a square box with text in the middle without having to take the entire horizontal space. I am trying to create new forms with our Logo on top left or right hand corner and then have the heading in the rest of the space. I will also need to have boxes side by side with lists in each box to be checked against etc. on the forms.

Thanks.